Preliminary evaluation of dual-energy CT to quantitatively assess bone marrow edema in patients with diabetic foot ulcers and suspected osteomyelitis

• Published in: European radiology 2023-08, Vol.33 (8), p.5645-5652
• Main Authors: Mens, M. A., de Geus, A., Wellenberg, R. H. H., Streekstra, G. J., Weil, N. L., Bus, S. A., Busch-Westbroek, T. E., Nieuwdorp, M., Maas, M.
• Format: Article
• Language: English
• Subjects: Bone marrow; Calcium; Diabetes; Diabetes mellitus; Diagnosis; Diagnostic Radiology; Edema; Evaluation; Feet; Foot diseases; Imaging; Internal Medicine; Interventional Radiology; Leg ulcers; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Osteomyelitis; Patients; Radiology; Statistical analysis; Ulcers; Ultrasound
• ISSN: 1432-1084; 0938-7994; 1432-1084
• DOI: 10.1007/s00330-023-09479-2

Objectives The purpose of this study is to evaluate the value of dual-energy CT (DECT) with virtual non-calcium (VNCa) in quantitatively assessing the presence of bone marrow edema (BME) in patients with diabetic foot ulcers and suspected osteomyelitis. Methods Patients with a diabetic foot ulcer and suspected osteomyelitis that underwent DECT (80 kVp/Sn150 kVp) with VNCa were retrospectively included. Two observers independently measured CT values of the bone adjacent to the ulcer and a reference bone not related to the ulcer. The patients were divided into two clinical groups, osteomyelitis or no-osteomyelitis, based on the final diagnosis by the treating physicians. Results A total of 56 foot ulcers were identified of which 23 were included in the osteomyelitis group. The mean CT value at the ulcer location was significantly higher in the osteomyelitis group (− 17.23 ± 34.96 HU) compared to the no-osteomyelitis group (− 69.34 ± 49.40 HU; p